Salvage revision total knee replacement using the Endo-Model® rotating hinge prosthesis

Pradhan, Nikhil; Bale, Linda; Kay, PR; Porter, Martyn

doi:10.1016/j.knee.2004.03.001

Cited by 58 publications

(37 citation statements)

References 8 publications

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“…16,[22][23][24][25][26][27][28][29] Its use in the trauma setting has yet to be published. The prosthesis has antitorsional, antitilt and antimigration properties.…”

Section: Description Of Surgical Technique and Patient Managementmentioning

confidence: 99%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

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Introduction: Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy. Methodology: In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship. 6 of the 11 from the cohort had existing Total Knee Replacements (TKRs) in situ. Results: There were 11 knees in our cohort with a mean age of 81.5 years (range 52-102 years). The median time to follow up was 3.5 years (range 1.6 to 5.5 years). The median times to theatre was 3 days and to discharge was 16 days. Oxford functional and pain scores were 32/48. Discussion: In the appropriate patient and fracture pattern, Endoprosthetic knee replacement is an excellent option in the treatment of distal femoral fractures whether associated with an existing TKR or not. The implant is more costly than traditional open reduction and internal fixation, but the earlier return to full mobility post-operatively may save on hospital/care home stay and free up hospital space and minimise complications.

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“…16,[22][23][24][25][26][27][28][29] Its use in the trauma setting has yet to be published. The prosthesis has antitorsional, antitilt and antimigration properties.…”

Section: Description Of Surgical Technique and Patient Managementmentioning

confidence: 99%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

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“…Clinical studies of modern-generation rotating-hinge prostheses have been reported by numerous authors [2,6,9,[13][14][15][16]. Numerous authors have reported improvements in pain and function [2,9,10,13] and ROM [10,15] after the use of rotating-hinge prostheses.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

Biswas

Haughom

Mayle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although modern-generation rotating-hinge knee implants have been modified to mitigate earlier complications related to aseptic loosening with these devices in revision TKAs, there are few, if any, reports of failure related to the hinge mechanism in these prostheses. Case Description We present a case of disengagement of the hinge-post extension in a contemporary rotating-hinge knee prosthesis originally implanted during revision surgery for instability and extensor mechanism insufficiency. We hypothesize the screw home kinematics of the knee resulted in a counterclockwise torque, contributing to the hinge post locking screw disengagement in this case. Literature Review Although some authors have reported complications and failures related to aseptic loosening with rotating-hinge knee prostheses, there have been no reports regarding complications related to the hinge mechanism, which simultaneously links and permits rotation between the femoral and tibial components. Clinical Relevance Arthroplasty surgeons who use rotating-hinge knee prostheses need to be aware of this potential mode of failure. Design modifications, including more secure locking mechanisms and side-specific implants, may avoid this complication.

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“…Using augments is a bone-sacrificing option rather than a preserving one, as resection of more bone may be required to accommodate them. Hinged knee implants also have been used in revision TKAs with bone deficiency [27,28,34,43]. The reported survivorship rates range from 68% to 96% at followups ranging from 3 to 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…These include cementing of contained defects [21,29], the use of augments [6,25,26], modular and custom hinged knee implants [27,28,34,43], and bone grafting (morselized bone [5,20,[37][38][39][40]42], structural allografts [2,12]). The use of morselized bone, although widely used in revision hip surgery [3], has not been commonly reported in revision TKA studies.…”

Section: Introductionmentioning

confidence: 99%

Cementless Revision TKA with Bone Grafting of Osseous Defects Restores Bone Stock with a Low Revision Rate at 4 to 10 years

Hanna

Aston

Roeck

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Addressing bone loss in revision TKA is challenging despite the array of options to reconstruct the deficient bone. Biologic reconstruction using morselized loosely-packed bone graft potentially allows for augmentation of residual bone stock while offering physiologic load transfer. However it is unclear whether the reconstructions are durable. Questions/purposes We therefore sought to determine (1) survivorship and complications, (2) function, and (3) radiographic findings of cementless revision TKA in combination with loosely-packed morselized bone graft to reconstruct osseous defects at revision TKA. Patients and MethodsWe retrospectively reviewed 56 patients who had undergone revision TKAs using cementless long-stemmed components in combination with morselized loose bone graft at our institution. There were 26 men and 30 women with a mean age of 68.3 years (range, 56-89 years). Patients were followed to assess symptoms and function and to detect radiographic loosening, component migration, and graft incorporation. The minimum followup was 4 years (mean, 7.3 years; range, 4-10 years). Results Cumulative prosthesis survival, with revision as an end point, was 98% at 10 years. The mean Oxford Knee Scores improved from 21 (36%) preoperatively to 41 (68%) at final followup. Five patients (9%) had reoperations for complications. Conclusions Our observations suggest this technique is reproducible and obviates the need for excessive bone resection, use of large metal augments, mass allografts, or custom prostheses. It allows for bone stock to be reconstructed reliably with durable midterm component fixation.

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Salvage revision total knee replacement using the Endo-Model® rotating hinge prosthesis

Cited by 58 publications

References 8 publications

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

Cementless Revision TKA with Bone Grafting of Osseous Defects Restores Bone Stock with a Low Revision Rate at 4 to 10 years

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